title: The role of hypoxia-ischemia in term newborns with arterial stroke.
abstract: The role of generalized hypoxia-ischemia in the genesis of perinatal focal arterial stroke remains puzzling. Animal studies have demonstrated that hypoxia-ischemia may alter blood flow through the ductus venosus, thereby increasing the risk for placental emboli entering the cerebral circulation. A retrospective review was performed of clinical records of all term newborns admitted to a tertiary perinatal center between January 1995 and May 2007 with acute arterial stroke on neuroimaging during the first week of life. Newborns were classified into 2 groups on the basis of neuroimaging abnormalities: stroke alone, or stroke and nonfocal hypoxic-ischemic brain injury. A total of 62 newborns had focal or multifocal stroke, 36 with stroke alone and 26 with stroke with nonfocal hypoxia-ischemia. Multiple risk factors for hypoxia-ischemia occurred in most newborns in both groups. These data indicate that hypoxia-ischemia may play a role in the genesis of stroke in the term newborn with or without evidence of nonfocal hypoxic-ischemic brain injury on neuroimaging.
authors.affiliation: Department of Pediatrics, University of British Columbia, Vancouver, Canada.
authors.forename: Aspasia
authors.initials: A
authors.lastname: Michoulas
authors.forename: S Nigel
authors.initials: SN
authors.lastname: Basheer
authors.forename: Elke H
authors.initials: EH
authors.lastname: Roland
authors.forename: Ken
authors.initials: K
authors.lastname: Poskitt
authors.forename: Steven
authors.initials: S
authors.lastname: Miller
authors.forename: Alan
authors.initials: A
authors.lastname: Hill
mesh_terms: D001158:Arteries / Q000473:pathology / Q000503:physiopathology; D020520:Brain Infarction / Q000209:etiology / Q000473:pathology; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology